In an effort to support the delivery of high-quality primary care worldwide as an essential universal health coverage, World Health Organisation (WHO) is developing a primary care toolkit to improve and standardise data across primary care settings. In this project, evidence-informed checklists and encounter forms will be developed, allowing for the creation of a standardised dataset and an international registry for primary care.

To capture the wealth of expertise of those experienced in delivering primary care services worldwide, WHO is collecting examples of patient encounter forms that are currently used by primary care providers.

World Physiotherapy is assisting WHO by gathering this information from the global physiotherapy community. We are asking you to provide examples of physiotherapy patient encounter forms from the primary care setting where you work.

Please note that patient encounter forms in all languages are accepted.

We encourage you to fill in the following information and upload the relevant document in the place provided.  

Question Title

* 1. Contact details

Question Title

* 3. Name of the primary care institution using this form:

Question Title

* 4. Location of the primary care institution using this form:

Question Title

* 5. Upload the document

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File